New secretary won't solve VA's woes

Jun. 24, 2014 - 11:53AM
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Politics is like car racing, people don’t watch to see who wins as much as they watch to see who crashes. The resignation of Eric Shinseki as secretary of the Department of Veterans Affairs is the latest executive branch crash to excite the throngs in Washington.

VA is unique among federal agencies because its mission is to make people whole again, and serves as a lifelong lifeline to a diverse and often challenged population. Like many other hospitals and health care facilities, “healthy” or “whole” is addressed on an individual basis, and this makes the department among the most people-intensive agencies in government. The agency’s employees — from top to bottom — must be up to the job.

The president and Congress must use the present opportunity to enable the VA to succeed. The agency needs more than a new secretary: It needs to develop a leadership, management, and service delivery culture of patient-centered care, experience and management. This is a hallmark of the best hospitals in America. It is also a central emphasis of the Affordable Care Act, resulting in the Patient-Centered Outcomes Research Institute — currently receiving more than $150 million in annual appropriations for grant-based research, and potentially helpful to addressing the problems and helping patients at VA.

Here are some actions and principles that should be recognized as essential to foster improvements at VA:

■ Nominate a sabbatical secretary from a proven health care leadership position. The VA leadership, management and cultural transformation needs must be balanced with the reality and opportunities that are presented. The two-year term until the end of the Obama administration is an opportunity for a proven CEO and leader to take a sabbatical from a related position in a large complex health care leadership role to lead VA in its multiple transitions: from crisis to stability to excellence; and, from the end of one administration to the beginning of the next.

■ Demonstrate the key elements to lead change at VA. The new secretary must demonstrate the capability to successfully institute and lead change in complex health care systems, including hands on leadership and operational experience across a geographically and culturally diverse population. This is a job requiring the ability to personally inspire, gain confidence, manage through both performance and accountability, and honestly assess the capacity across VA, and where necessary replace people and revitalize programs and organizations.

■ Build upon the efforts, learning and achievements of the acting secretary and his team at VA. Acting Secretary Sloan Gibson is serving effectively as a catalyst for accountability, breaking the cycle and culture of mismanagement, serving as a fresh set of eyes and ears at the top, and creating a more accessible and responsive top management hub. .

■ Establish a VA Institute for Management. The purpose will be to screen and select potential managers and leaders to work at VA; and educate, train, credential and qualify candidates for positions. The VA Institute for Management must be a rigorous and sought after program, including using case studies from what is wrong at VA to learn and overcome such problems. A VA Institute for Management should replace the existing VA HR Academy.

■ Reject the proposed legislative changes to civil service laws for VA officials. The president should consider all proposed legislative reforms for the VA as a whole, while rejecting the proposed reforms to change the due process rights of senior career VA officials. Government has all the laws, regulations and tools in place to fire people. Changing the law would also make the agency significantly less attractive as a prospective federal employer to the types of experienced career government officials needed.

Steven L. Katz is the author of “Lion Taming: Working Successfully with Leaders, Bosses, and other Tough Customers.” He served as the chief counsel to the chairman of the U.S. Merit Systems Protection Board; senior advisor to the Comptroller General of the United States, agency head of GAO; and counsel to the Senate Committee on Governmental Affairs.